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April 3, 2026Journal of Surgical Research0 citationsOpen Access

In-Hospital Outcomes of Robotic-Assisted Cholecystectomy in Obese versus Normal-Weight Patients: A National Inpatient Sample Analysis

PDPalak Dutta RGRohit Ganduboina ASAman Sinha

Key Points

This analysis aims to compare in-hospital outcomes of robotic-assisted cholecystectomy between obese and normal-weight patients.
Retrospective analysis of National Inpatient Sample data from 2016 to 2021.
Identified 15,048 adults undergoing robotic-assisted cholecystectomy.
Divided patients into obese (BMI ≥ 30) and normal-weight (BMI 18-25) groups.
Analyzed demographics, comorbidities, hospital characteristics, and outcomes using multivariable models.
Thirty percent of robotic-assisted cholecystectomy patients were obese.
Obese patients were younger than normal-weight individuals (median age 50 vs. 57 years).
Obese individuals had lower mortality rates (adjusted OR 0.27) and lower infection rates (adjusted OR 0.33).
No significant differences in other complications or conversion to open surgery.

Abstract

Introduction: Obesity increases perioperative risks in cholecystectomy due to its association with gallbladder disease.Robotic-assisted cholecystectomy (RC) may mitigate technical challenges in this population.This study compares in-hospital outcomes of RC between obese (BMI 30 kg/m 2 ) and normal-weight (BMI 18-25 kg/m 2 ) patients using National Inpatient Sample data.Methods: A retrospective analysis of National Inpatient Sample data (2016-2021) identified 15,048 adults undergoing RC.Patients were stratified into obese (n = 4570) and normalweight (n = 10,478) groups.Demographics, comorbidities, hospital characteristics, and in-hospital outcomes were analyzed using multivariable models.Results: Thirty percent of RC patients were obese.Obese individuals were younger than normal-weight patients (median 50 versus 57 y, P < 0.001) and had lower mortality (adjusted OR 0.27, 95% CI 0.10-0.60,P = 0.004) and infection rates (adjusted OR 0.33, 95% CI 0.09-0.89,P = 0.05), with no significant differences in other complications or open conversion.Conclusions: RC is increasingly performed in obese patients and appears safe in appropriately selected individuals.Despite higher comorbidity burdens, obese patients demonstrated lower in-hospital mortality and similar complication rates.Potential selection bias and lack of long-term outcome data warrant cautious interpretation.

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